Key result
LV systolic dysfunction shows no association with arterial stiffness in idiopathic pulmonary arterial hypertension.
Why the study?
This study aimed to evaluate LV systolic and diastolic function in patients with IPAH and its correlation with systemic arterial stiffness assessed by CAVI.
Cross-Sectional (n=57)
No
Absolute Event Rate: 8.8% vs 8.6%
p-value: p=0.73
Patients with idiopathic pulmonary arterial hypertension exhibit worse left ventricular systolic and diastolic function and increased arterial stiffness compared to healthy controls, though these parameters do not directly correlate.
No association between LV strain and CAVI in IPAH suggests limited direct clinical relevance; leaves open independent contribution of RV ejection time to stiffness.
Abstarct: Aim: This study aims to evaluate the left ventricle (LV) systolic and diastolic function in patients with idiopathic pulmonary arterial hypertension (IPAH) and its correlation with systemic arterial stiffness assessed by cardio-ankle vascular index (CAVI). Patient and methods: We included 37 patients with IPAH and 20 healthy people matched by age. All patients were assessed: vital signs, 6-minute walk test, NT-proBNP level, the CAVI, the right ventricular (RV) and LV function parameters, including ejection time (ET), tissue speckle-tracking values – global longitudinal strain (GLS) and strain rate (SR). Results: The groups were matched by age, gender, BMI, office SBP and DBP. Patients with IPAH had higher heart rate, NT-proBNP level and lower ferritin level, GFR (CKD-EPI), SaO 2 than healthy people. The mean CAVI left was higher in IPAH patients than in the control group- 8.7± 1.1 vs 7.5± 0.9, P=0.007. Healthy people had significantly less E/e’ and lower IVRT. LVET and RVET were shorter in IPAH patients. Patients with IPAH had mean LVGLS –(− 17.6± 4.8%) and 35.1% of them were with LVGLS ≤ 16% compared to healthy people –(− 21.8± 1.4%) and 0%, respectively. LVSR was significant less in IPAH patients, but in the normal range. We found significant correlations of CAVI with age, history of syncope, bilirubin, uric acid, total cholesterol, cardiac output, cardiac index, RVET, LVET and E/A. Multiple linear regression confirmed the independent significance for age (β=0.083± 0.023, CI 0.033– 0.133) and RVET (β=-0.018± 0.005, CI -0.029 to − 0.008) only. The risk to have CAVI ≥ 8 increased in 5.8 times in IPAH patients with RVET < 248 ms (P=0.046). CAVI did not correlate with LVGLS and LVSR. Conclusion: Significant worse systolic and diastolic LV functions were stated in pulmonary hypertensive patients compared to the control group. No LV GLS, no LV SR had significant associations with arterial stiffness evaluated by CAVI.
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Radchenko et al. (2022) conducted a cross-sectional in Idiopathic pulmonary arterial hypertension (n=57). Left ventricular systolic dysfunction (LVGLS ≤16%) vs. Normal left ventricular systolic function (LVGLS >16%) was evaluated on Cardio-ankle vascular index (CAVI left) (p=0.73). In patients with idiopathic pulmonary arterial hypertension, left ventricular systolic dysfunction evaluated by global longitudinal strain had no significant association with arterial stiffness as measured by the left cardio-ankle vascular index (8.8 vs 8.6, P=0.73).
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